Weekend Ramble: Vegetarian & Plant Based Eating

I'm not gonna lie... I'm not a huge fan of plant based eating as I firmly believe I was born a carnivore. I do, however, respect people's choices regarding healthy foods and I have even been known to embrace some vegetarian dishes as they cross my path. Since my audience is global, I thought I should do at least one Ramble on the subject.

To that end, here is a very good article originally published by Beth Israel Lahey Health's Joslin Diabetes Learning Center

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Vegetarian and Plant Based Eating

Joslin Education Team - March 29, 2022

A plant-based diet consists of mostly whole grains, fresh fruits and vegetables, legumes (pulses), unsalted nuts, and healthy oils such as olive oil or canola oil. Meat, fish, poultry, and other animal products are included but eaten less often and only in small portions. A vegetarian diet eliminates meat, fish, or poultry or any foods that contain animal protein. It includes whole grains, legumes (pulses), nuts, seeds, vegetables and fruits with or without the use of dairy products and eggs.

There are several different types of a vegetarian diet:

• Semi-vegetarian: Does not eat red meat(s), but occasionally eats fish or poultry and dairy products. Semi-vegetarians are often people who are making a transition to a vegetarian diet.
• Lacto-ovo vegetarian: Eats milk, dairy products and eggs but not meat, fish or poultry.
• Lacto-vegetarian: Eats milk and other dairy products but not meat, fish, poultry or eggs.
• Pescetarian: Eats a diet of fruits, vegetables, grains, legumes and includes fish. They may or may not eat eggs and dairy
• Vegan: Do not eat any animal products (meat, fish, poultry, eggs or dairy foods). A vegan eats only plant-based foods.
• Raw Vegan: Eats only plant foods; including vegetables, fruit, nuts and seeds, legumes (dried beans, peas, and lentils), and sprouted grains. The majority of the food is uncooked varying from 75% to 100%.

Can people with diabetes follow a vegetarian or plant-based diet?

Research shows the many benefits of omega-3 fatty acids. They may reduce the risk for cardiovascular disease, improve cognitive function and vision, and act as an anti-inflammatory agent in the body. The primary sources of omega-3 fatty acids in the diet are fish, organ meats, and DHA-enriched foods such as eggs. Based on these food sources, vegetarians may not get enough omega-3 fatty acids in their diet. Adding some plant-based omega-3 rich foods can help the vegetarian meets their needs.

What are the health benefits?

There are many reasons why people choose to follow a vegetarian or a plant-based diet, including financial reasons, ethical, environmental concerns and religious beliefs. Some people make the change for health reasons, as well. Vegetarian and plant-based eating may help reduce the risk of:

• Cancer
• Diabetes
• Heart disease
• High blood pressure
• Kidney disease
• Obesity

Yes. They can be higher in carbohydrates and lower in protein than meat-based diets, so glucose levels may be affected. As a result, your healthcare provider may need to change the amount or type of your diabetes medicine. Anyone interested in changing to vegetarian or plant-based eating, including people with diabetes, should work with a dietitian to make sure they are meeting their nutritional needs.

Is vegetarian/plant-based eating nutritionally adequate?

A well-planned vegetarian/plant-based diet can be healthful and nutritionally adequate. Keep in mind that the more restricted the diet, the greater the chance of a nutritional deficiency. Below are some considerations.

Protein:

Vegetarian/plant-based diet(s) can provide an adequate amount of protein as long as you eat a variety of foods and consume adequate protein sources. Protein is made up of amino acids, nine of which are called essential amino acids. Animal foods contain all of the essential amino acids, whereas plant foods are missing one or two. However, if you eat a variety of plant foods, you will get all nine essential amino acids.

Sources of Plant Protein:

Legumes (Pulses)

Legumes include dry beans, peas, and lentils. They are an excellent food to extend or replace meat. Legumes are low cost, high in nutritive value, and contribute iron, B vitamins, and fiber to your diet. They are not a complete protein, because they do not contain all of the essential amino acids the body needs. When combined with a variety of other plant-based foods throughout the week, legumes can become valuable protein sources in your diet. Legumes may be purchased dry or canned. Dry legumes tend to be less expensive

Dry Beans: Rich in protein, iron, calcium, phosphorus and potassium. There are many varieties of dry beans including black beans, garbanzo beans (also called chickpeas), kidney beans, lima beans, navy beans and pinto beans.

Dry Peas: Good sources of protein, iron, potassium and thiamin. They are green or yellow and can be purchased split or whole.

Lentils: They are rich in protein, iron, potassium, calcium and phosphorus. They are small disc-shaped legumes; they can be brown, yellow or red.

Soy Products: Soy products include tofu, soymilk, tempeh and other products. They are derived from soybeans, a rich source of plant-based protein. Protein in soybeans contains as much complete protein as meat and are a good source of B vitamins and essential fatty acids, including some omega-3s. Soy foods are typically low in unhealthy fats (saturated/trans) and are cholesterol-free. They also contain isoflavones which may help lower the risk of some chronic diseases.

Soybean: A legume, which is an excellent, inexpensive source of protein and iron. Soybeans can be eaten in their whole form and, but are also used to make a number of vegetarian substitutions for meat, dairy, and eggs.

Soy cheese: A cheese-like product made from soybeans. They come in a variety of flavors such as parmesan, mozzarella and cheddar. Not all soy cheeses are vegan; some contain the milk protein casein.

Soymilk: A milk-like product made from soybeans, with a similar amount of protein and less fat than cow’s milk. Not all soymilks are vegan as some contain the milk protein casein. Fortified soymilks have calcium and vitamin D added.

Tempeh: Made from fermented soybeans and other grains, tempeh is a replacement for meat.

Textured Soy Protein (TSP): Commonly used as a substitute for ground beef; TSP is derived from soy flour.

Tofu: Made from curdled soymilk and pressed into blocks. It can be used as a replacement for meat, eggs and cheese and can be eaten fresh or cooked in many different ways. Tofu is an excellent source of protein. Types and suggestions of how to use tofu:

• Extra-firm tofu: frying, roasting, grilling or marinating
• Firm tofu: stir-frying, boiling or use as a filling
• Soft tofu: pureeing
• Silken tofu: pureeing, simmering, egg substitution, used in vegan desserts and smoothies

Nuts and Seeds:

Nuts and seeds are some of the best plant sources of protein. They are rich in fiber, folic acid, potassium, antioxidants (vitamin E and selenium) and phytochemicals as well. Nuts are high in monounsaturated and polyunsaturated fatty acids, including omega 3 fatty acids. Because nuts and seeds are high in fat, portions should be limited.

• Tree nuts: Includes almonds, Brazil nuts, cashews, hazelnuts, macadamias, pecans, pine nuts, pistachios and walnuts.
• Seeds: Includes pumpkin, sesame, sunflower, chia and flaxseed.
• Nut Butters: Peanut butter is the most popular but other nuts and seeds make butter: sunflower, almond, cashew, hazelnut and soy.

Omega-3 Fatty Acids

Sources of Omega-3 foods:

• Flaxseed
• Chia seeds
• Hemp seeds
• Walnuts
• Canola oil
• Soy
• Some soymilks and breakfast bars

Iron:

Plant foods contain a different form of iron than animal foods, called non-heme iron. Non-heme iron is not as well absorbed as heme iron. Non-heme iron will be better absorbed if eaten along with foods that contain vitamin C, or by cooking foods in cast-iron pots and pans. The daily recommendation for iron intake is 1.8 times higher for vegetarians than those who eat meat. For most vegetarians, an iron supplement is recommended to help meet iron requirements.

Sources of iron:

• Bran flakes cereal Pumpkin seeds Instant oatmeal Dried beans/peas Fortified cereals Tofu
• Sea vegetables Textured vegetable protein

Sources of vitamin C:

• Cantaloupe 
• Strawberries
• Honeydew melon 
• Broccoli
• Citrus fruits 
• Green peppers
• Kiwi 
• Tomatoes
• Papaya 
• Brussels sprouts

Zinc:

As with iron, zinc is a mineral that is present in plant foods but better absorbed from animal sources. As a result, some vegetarians can have lower concentrations of zinc than non-vegetarian diets. Most vegetarians still have levels within the normal range. True zinc deficiencies are rare in Western civilizations. Including foods rich in zinc can help the vegetarian maintain adequate levels of zinc in their body. Like iron, zinc can be better absorbed when eaten in combination with vitamin C-rich foods. (See list above)

Sources of Zinc:

• Legumes
• Grains
• Cheese
• Nuts

Vitamin B-12:

Vitamin B-12 is found mainly in animal foods. Some plant foods contain vitamin B-12, but not in a usable form. A lacto-ovo or lacto-vegetarian diet will provide adequate amounts of vitamin B-12. Certain foods are fortified with vitamin B-12, such as some breakfast cereals, soymilk and meat substitutes. If you are a vegan, you must either make sure you eat these fortified foods, or take a B-12 supplement.

Sources of Vitamin B-12:

• Fortified cereals 
• Eggs
• Brewer’s yeast Milk and milk products
• Fortified meat substitutes 
• Fortified soy milk

Calcium:

A lacto-ovo vegetarian diet generally is adequate in calcium. A vegan diet tends to provide lower amounts of calcium, although, with careful planning, a vegan diet can supply enough calcium. Your dietitian may recommend a calcium supplement if you can’t meet your calcium needs through food sources.

Note: Calcium decreases the absorption of iron. If taking supplemental calcium or iron, take them at separate times of the day.

Sources of calcium:

• Milk and milk products 
• Legumes
• Fortified soy milk 
• Collard greens
• Tofu (made with calcium) 
• Turnip greens
• Fortified orange juice 
• Kale

Vitamin D:

Vegan diets may be low in vitamin D, since cow’s milk is the most common source of this vitamin. However, if you follow a vegan diet, you can get enough vitamin D from fortified cereals and fortified milk alternatives. Unprotected exposure to sunlight (hands and arms) for 15-20 minutes a day can also supply adequate vitamin D. Some people may need a vitamin D supplement. Your dietitian may recommend supplemental vitamin D if your diet is deficient and/or your vitamin D level is low.

Sources of vitamin D:

• Fortified cereals 
• Fortified soy milk
• Milk
• Sunlight

Getting started with vegetarian/plant-based meal planning

Choose a variety of foods, including whole grains, vegetables, fruits, legumes, nuts, seeds, and, if desired, dairy products and eggs.

Try gradually decreasing the amount of animal protein to allow time to adjust to a vegetarian/plant-based diet.

Substitute soy products (tofu, meat substitutes) and legumes for meat, poultry and fish.

If you use milk products and eggs, choose lower-fat versions of these foods, such as skim or 1% milk and yogurt, and egg whites or egg substitutes.

If you are following a vegan diet, be sure to include a regular source of vitamin B-12 in your diet along with a source of vitamin D if sun exposure is limited. Supplements are often required to meet nutrient needs.

Use fats sparingly; choose unsaturated fats, such as olive, canola and peanut oils, nuts and seeds, instead of saturated fats, such as butter, margarine and cream cheese.

Limit your intake of high-fat foods, such as cheeses, whole milk, nuts, seeds, avocados and oils, especially if you are trying to lose weight.

Be sure to count the carbohydrates in foods – many vegetarian diets can be very high in carbohydrates. Keep your carbohydrate intake consistent and read food labels carefully for their carbohydrate content.

It is important to monitor your glucose regularly if you are changing to a vegetarian diet/plant-based diet. Your diabetes medication or insulin dose may need to be adjusted, especially if you are eating more carbohydrates than before.

Vegetarian meal ideas

Below are some meal ideas to help get you started? Again, be sure to include a variety of foods in your eating plan.

• Breakfast: Whole-grain cereal and skim/1% fat or milk alternatives; whole-grain toast; bagels; English muffins; pancakes and waffles; fruit; eggs and egg substitutes; nonfat Greek yogurt; regular/low-fat cheeses; peanut and nut butter; tofu “cream cheese”; vegetarian/plant-based proteins “bacon” and “sausage”.
• Lunch/Supper: grilled cheese sandwich; hummus and vegetable sandwich; peanut butter and jelly sandwich; minestrone, bean, split pea and lentil soups; vegetable pizza; rice and beans; bean and vegetable burritos bowls; macaroni and cheese; vegetarian lasagna; stir-fry vegetables and tofu; “veggie/plant-based” burgers; vegetarian-style chili

Note: Many vegetarian and planted-based frozen products are not necessarily healthy choices. Some of the products can be high in calories and fat. Always read the nutrition facts to make sure the item is appropriate for your goals. 

Resources:

The Vegetarian Resource Group - https://www.vrg.org/
Eating Vegetarian - https://www.nutrition.gov/topics/basic-nutrition/eating-vegetarian
Vegetarian Times - https://www.vegetariantimes.com
Mark Bittman - https://www.markbittman.com/
PBS, Jazzy Vegetarian Cooking Show - http://www.pbs.org/food/shows/jazzy-vegetarian/
Forks over Knives - https://www.forksoverknives.com/
The Plant-Based Network - https://plantbasednetwork.com

Although this content is reviewed by Joslin Diabetes Center healthcare professionals, it is not intended to replace the medical advice of your doctor or healthcare provider. Please consult your healthcare provider for advice about a specific medical condition.

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Have a great week, everyone, and thank you for your support!

Blessed be… and happy cooking!

                                                            Chef Michael R

Asian-Italian Chicken Tenders

This dish was born of a missing ingredient when I was up at Sylvan Run and had decided on Chicken Tenders Lyon for dinner. As I was gathering my ingredients I realized I had no muffuletta (olive salad). Chef Pepin's philosophy of "using what you have in the refrigerator" came to mind and a new dish with an Asian/Italian flair was born. Enjoy!

Ingredients:

• 5-6 chicken tenders, trimmed if needed
• whole milk or half & half
• Wondra flour
• 1 tbsp avocado oil
• salt & pepper
• 4 cloves garlic, smash minced
• 1 shallot - minced
• 4 tbsp rice wine vinegar
• 4 tbsp water
• 4 tbsp ginger teriyaki marinade
• dash of tabasco or sriracha
• shredded mozzarella - or sliced Swiss cheese
• minced scallions for garnish (optional)

Preparation:

Trim any ligament ends from tenders and lay them side by side on a plate. Add S & P to both sides.

Heat a frying pan with avocado oil. Dredge tenders through milk and flour and brown them on both sides. Once chicken is well browned, cover and steam rest of the way on low for 4-5 minutes.

Remove chicken from pan and place on warmed serving dish with a cover. Add garlic and shallot to the pan and saute on medium heat for a minute or so. 

Add the vinegar and reduce on high heat to remove acidity. Taste… Add water, ginger teriyaki marinade and sriracha and stir until well blended. 

Return chicken to the pan and cover with sauce and mozzarella. Turn heat to low and put the lid on. Once cheese is melted, remove from heat, add garnish and serve.

Blessed be... and happy cooking!

Baked Cinnamon Apples

Everyone knows that apples are a fun and healthy snack year-round, right? :-)

In this recipe from the Diabetic Cookbook for Beginners - 2024 Edition there is no sugar or sweetener added so I suggest staying away from anything tart and sticking to a sweet variety like Honey Crisp. The end result can be eaten warm from the oven or as a cold snack later on. Enjoy!

Ingredients:

• 4 large apples - peeled, cored and sliced
• 2 tbsp unsalted butter - melted
• 1 tbsp ground cinnamon

Preparation:

Toss the apple slices with the ground cinnamon until evenly coated.

Add the melted butter and toss until apples are fully coated.

Pour mix into an oven-proof dish, spread evenly and bake at 375 degrees for 25 minutes or until tender.

Blessed be... and happy cooking!

Squash... 'n' Stuff

Today's dish is brought to you courtesy of The Splendid Table. Interesting flavors for those who enjoy citrus and acidic flavors, but next time I make this I think I'll opt for using it as a party salad. Next day leftovers were really good cold :-)

Ingredients:

• 1 spaghetti squash (3 pounds), halved lengthwise and seeds removed 

• 6 slices turkey bacon 

• 2 tablespoons balsamic vinegar 

• 1 teaspoon fresh lemon juice 

• 1/4 cup extra virgin olive oil 

• 2 tablespoons chopped fresh flat-leaf parsley leaves 

• 1/4 teaspoon kosher or fine sea salt 

• 1/8 teaspoon freshly ground black pepper 

• 1/3 cup pine nuts, toasted 

Preparation:
Looking like a large, pale yellow football with rounded ends, spaghetti squash has a unique texture. When cooked, the pulp comes out in strands as thick and long as spaghetti noodles. Cut in half, the squash can be oven-baked in less than an hour or microwaved in a rapid 15-20 minutes. The long threads of vegetable goodness can then be forked out, topped, garnished, herbed, buttered, or tossed with cheese, nuts, or other vegetables in simple, exorbitant, conservative, or outrageous splendor. Here bacon, pine nuts, and a touch of lemon juice and vinegar produce an ambrosial warm salad.

If oven-baking, preheat the oven to 375°F.

Place the squash, cut sides down, on a baking sheet or microwave-safe dish. Cover and cook until collapsing and soft all the way through, about an hour in the oven, 15-20 minutes in the microwave. Place the bacon alongside the squash on the baking sheet for the last 20 to 25 minutes, or place the slices between 2 paper towels and microwave until crisp, 3 to 4 minutes. (Or just fry up the bacon while toasting the pine nuts) Remove and let cool enough to handle.

Scoop the squash out of its shell and place the strands on a platter. In a small bowl, stir together the vinegar, lemon juice, olive oil, parsley, salt, and pepper. Pour over the squash. Sprinkle the pine nuts and crumble the bacon over the top and toss gently to mix. 

Serve right away or at room temperature. If using the dish as an app, toss everything gently and serve 1/2 - 3/4 cup per person.

Blessed be... and happy cooking!

Baked Zucchini Boats Parmesan

Here's another way to use ground white meat chicken or lean ground beef, and you can have fun stuffing the zucchini by seasoning the meat any number of ways. As Chef Jacques Pepin always says... "Never be afraid to make a dish your own!" I like to go easy on the seasoning so the protein mostly speaks for itself. Plenty of flavor comes from the zucchini as well as the cheese so I don't see a reason to go heavy on spices. If you want to, though..... GO FOR IT! :-)

Ingredients:

• 2 zucchini 
• 1 tbsp olive oil
• 1 lb ground chicken or lean beef
• 1/2 yellow onion - diced
• 2 cloves garlic - smashed & minced
• 1 lge tomato - diced
• S&P to taste
• part skim mozzarella - cut in pieces that will cover meat

Preparation:

Remove stem end from zucchini, cut in half lengthwise and scoop out seeds to create a zucchini boat. Brush with olive oil inside and out and bake skin side up, right on a cookie sheet or a raised rack, at 400 for about 8 minutes.

While that's going, fry up previously prepared meat, garlic, onion and tomato with the olive oil. Season with salt & pepper to taste. Have fun with other seasonings, too, if you like.

Below: Chicken or beef... your choice 

Place cooked zucchini in a baking dish and fill each one with meat mix. If not all of it fits... you get to enjoy a little snack later. ;-)

Cover the meat with generous slabs of mozzarella. Return baking dish to the oven and broil low until cheese melts and displays a golden brown. 

Serve with salad and maybe some quick cook barley blended with sauteed onions.

Blessed be... and happy cooking!

Lemon Caper Mahi Mahi & Onions

Here's another winning fish dish by my friend Betsy. This time she has combined onions with lemon and capers to create something uniquely different. Enjoy!

Modified By: Betsy Kelp Galloway (from Romulo Yanes, Gourmet Magazine)

Ingredients:

• 2 (6-oz) mahi mahi or halibut filets
• salt to taste
• ½ tsp black pepper, divided
• 2 ½ tbsp olive oil - divided
• 1 large onion - halved lengthwise - then thinly sliced crosswise
• 3 tbsp dry white wine
• 1 tbsp butter
• 3 tablespoons capers - rinsed, drained & coarsely chopped
• 2 ½ tbsp fresh lemon juice
• 1-2 tbsp fresh flat-leaf parsley - chopped

Preparation:

Pat thawed fish thoroughly dry. Sprinkle both sides of fish with salt to taste and ¼ tsp of the pepper, set aside.

Heat 1 ½ tbsp oil in a large skillet over medium high heat until shimmering then sauté onions, stirring frequently, until golden, about 6 minutes.

Stir in wine and ¼ tsp pepper. Cook, stirring, until onions are softened and wine reduces to about 1 tbsp, 2-3 minutes. Stir in butter until melted. Then stir in capers and lemon juice. Remove from heat, cover, and keep warm.

In another skillet, heat remaining olive oil (barely cover bottom of the pan to prevent sticking) over medium high heat until oil shimmers. Carefully place fish, serving side down, in the skillet. Do not disturb for 3 minutes to achieve golden color.

Carefully turn fish over and continue to cook to desired level of doneness (do not overcook as fish will be dry and tough), depending on the thickness and type of fish used, about 2-4 more minutes until fish begins to flake.

In the meantime, make a bed of the onion mixture on a serving platter, reserving 2 tbsp. Place fish on top of the bed of onions. Mix diced parsley into reserved 2 tablespoons of onions mixture and place on fish. Serve immediately.

Blessed be... and happy cooking!

Creamy Chicken Apple Salad

Credit for this protein-rich salad goes to the ADA's Diabetes Food Hub

This salad is a low-carb, power-food dynamo. Easy to prepare and packed full of good nutrition—protein from chicken, fiber from the apple, and healthy fat from the walnuts—this is a quick diabetes-friendly recipe that's perfect for lunches and making ahead. Full of flavor and crunch—you won’t believe how easy it is!

Ingredients:

• 2 cups cooked chicken breast (chopped)
• 2 stalks celery (diced)
• 2 green onions (chopped)
• 1 medium Jonagold apple (finely diced)
• 3 tbsp walnuts (chopped)
• 1/4 cup light mayonnaise
• 1/4 cup yogurt (plain, fat-free)
• 1/2 lemon (juiced)
• 1/8 tsp black pepper

Preparation:

In a medium bowl, combine the chicken, celery, green onions, apple, and walnuts

In a small bowl, whisk together the mayonnaise, yogurt, lemon juice and pepper. Pour over the chicken mixture and gently stir to coat.

Serve salad over your choice of lettuce leaves, bread or crackers.

Blessed be… and happy cooking!

Weekend Ramble: Hail Hydrate!

I think we can all agree that hydration is needed to survive. Hydration is especially important for us diabetics so that our systems can operate at max efficiency... you know... that well oiled machine theory. ;-) 

A constant struggle for many seems to be just how much hydration we need on a daily basis. There are different schools of thought on quantities of daily water consumption, the main one pushing for 64 oz of water daily, regardless of gender and body weight. 

I have always questioned this one, because I just don't see a 125 lb person needing the same intake as someone at 250 lbs. Gender is probably another factor, but that's a topic for another day. 

I recently came across some research that purports drinking half your body weight equated to water ounces for daily consumption. For example, a person like me weighing 210 lbs would consume 105 ounces of liquid over the course of 24 hrs.

Three of these just about do the trick for me for one day.

Flavored seltzer is my beverage of choice because there are no sweeteners or salts. I may fill one or more of these with plain water and a squeeze of real lemon, too.

Seltzer may not be everyone's choice, and I get that. The idea is to find beverages that not only work for you, but that also work FOR you from a diabetic standpoint. In that search, I recommend steering clear of anything labeled "Sugar Free" that is instead loaded with artificial sweeteners.

To that end I would like to share with you two articles that provide good guidelines on how to structure good diabetic hydration. Enjoy!

THE BEST AND WORST DRINKS FOR DIABETES

By JENNIFER NADEL, MD

Dr. Jennifer Nadel is a board certified emergency medicine physician and received her medical degree from the George Washington University School of Medicine. She has worked in varied practice environments, including academic urban level-one trauma centers, community hospital emergency departments, skilled nursing facilities, telemedicine, EMS medical control, and flight medicine.

People who have type 2 diabetes need to be aware of how drinks can affect their blood sugar levels. Certain beverages can increase glucose. Luckily, there are plenty of tasty drinks that people living with diabetes can enjoy.

In this article, we’ll explore the best and worst drinks for diabetes and how to make the best choices for supporting balanced blood sugar.

Best Drinks for Diabetes

If you have type 2 diabetes, staying hydrated can help support healthy blood glucose levels. However, some beverages make it harder to control blood sugar. The following are the best drinks to enjoy if you have type 2 diabetes.

Water

Proper hydration is key for a number of essential bodily functions, including removing waste, transporting nutrients, and cell metabolism. And when it comes to hydration, water is the best drink option for everyone, including those who have type 2 diabetes.

Drinking enough water each day can help keep blood sugar levels balanced. While each person’s water requirement differs based on body weight and activity levels, the Institute of Medicine suggests the following daily water needs:

Adults assigned male at birth: 3.08 liters (about 13 cups)

Adults assigned female at birth: 2.13 liters (about 9 cups)

Your medical provider can share specific guidance on how many cups of water to aim for. If you dislike plain water, you can make it more appealing by:

Adding ice

Trying filtered water versus tap water

Infusing it with citrus or cucumber slices

Adding fresh herbs like mint or basil

Herbal Tea

Herbal teas can add flavor and variety to your daily fluid intake. Herbal teas do not contain calories or carbohydrates. Many contain beneficial compounds, like flavonoids, that can offer health benefits.

Herbal tea options include:

Peppermint

Chamomile

Ginger

Raspberry

Hibiscus

Rooibos

Remember: Adding honey or sugar to herbal tea will affect your blood sugar. If you do not like plain herbal tea, consider boosting the flavor with freshly squeezed lemon juice or a sugar-free sweetener.

Unsweetened Iced Tea

People who have type 2 diabetes can enjoy black and green teas. Research has found that green tea in particular is rich in flavonoids and may reduce the risk of type 2 diabetes.

If you want to add more flavor to unsweetened tea without adding sugar, try lemon or other fruit infusions.

Unsweetened Black Coffee

Caffeinated black coffee is not necessarily bad for blood sugar. Research has associated the unsweetened beverage with a reduced risk of type 2 diabetes and improved long-term management of blood sugar responses in the body. However, adding sugar or milk may disrupt blood sugar balance.

Sugar-Free Sparkling Water

Seltzer water or sparkling water can make daily hydration more interesting. Many brands and flavors of sparkling water contain no added sugar or sweeteners, making them a good option for supporting daily hydration. They are also a good swap for soda or other carbonated drinks.

When selecting sparkling water, read the labels. Look for beverages that contain no calories or added sugars or sweeteners. You can also add citrus slices and fruit infusions to sparkling water to create an even richer flavor.

Worst Drinks for Diabetes

When managing type 2 diabetes, some drinks are a lot worse than others for causing glucose problems.

Fruit Juice

While drinks that contain 100% juice may offer some nutritional value (such as vitamin C), it’s best to consume whole fruit. Fruit juice contains all the carbohydrates but little of the fiber that’s naturally found in fruit. This can lead to blood sugar spikes.

If you are going to drink fruit juice, choose one with no added sugars and limit your intake to a half-cup (4 ounces). You can also add a few tablespoons of 100% fruit juice to plain or sparkling water, which minimizes added sugars while giving some of the desired flavor.

Soda

Most people who are managing type 2 diabetes know that soda can be problematic. One 12-ounce sugar-sweetened soda drink can contain more than 40 grams of sugars and 150 calories. If someone consumes soda from a restaurant, the cup size is usually 16 or 20 ounces, which only increases the amount of sugars consumed.

While diet soda doesn’t contain sugar, research does not definitely rule out any association with diabetes. If you are going to occasionally consume soda, diet soda is better for blood sugar control. But water, sparkling water, herbal teas, and black coffee are the best beverage choices for people who have type 2 diabetes.

Sweet Tea

Unsweetened black or green tea are good options for people who have type 2 diabetes. However, sweet tea contains as much or more sugar than regular soda: A 20-ounce bottle contains about 55 grams. Sugar-sweetened beverages are associated with a higher risk for type 2 diabetes and more problems with controlling blood sugar levels.

Energy Drinks

Energy drinks are typically high in carbohydrates and sugars, which can lead to blood sugar disruptions. In some cases, people are accustomed to consuming 2-3 energy drinks per day, which can lead to significant increases in blood sugar levels, blood pressure, and body weight.

Alcohol

Alcohol can lead to problems controlling blood sugar because it initially may lead to a decrease in glucose levels, but eventually could contribute to insulin resistance or overall health issues that are associated with type 2 diabetes, like obesity, heart problems, or high blood pressure. Some alcohol beverages also contain added sugars. Additionally, some research has linked regular elevated intakes of alcohol with an increased risk for prediabetes.

The American Diabetes Association suggests that people who have type 2 diabetes consume limited amounts of alcohol. That means two drinks or less per day for people assigned male at birth, and one drink or less for people assigned female at birth. Your medical provider may recommend less than this, especially if you consume medication that could interact with alcohol or you have other health-related factors that may be worsened by alcohol intake.

Bottom Line

If you have type 2 diabetes, you do not only have to drink plain water. There are many flavorful options for healthy drinks. Avoiding beverages that contain added sugars is an important part of managing blood sugar.

K Health articles are all written and reviewed by MDs, PhDs, NPs, or PharmDs and are for informational purposes only. This information does not constitute and should not be relied on for professional medical advice. Always talk to your doctor about the risks and benefits of any treatment.

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This second article focuses on a favorite of mine... carbonated water. There are many carbonated beverages out there... some, like quite a few sparkling waters, are loaded with artificial sweeteners... Always read labels when you make your choices. :-)

Carbonated (Sparkling) Water: Good or Bad?

By Franziska Spritzler — Updated on February 24, 2023  at  Healthline.com

Many people question if this beverage may have a negative impact on your dental, digestive, or bone health. However, it’s often co nsidered to be a healthy way to stay hydrated.

Carbonated water is a refreshing beverage and good alternative to sugary soft drinks. However, some people are concerned that it may be bad for your health. This article takes a detailed look at the health effects of carbonated water.

What is carbonated water?

Carbonated water is water that has been infused with carbon dioxide gas under pressure. This produces a bubbly drink that’s also known as sparkling water, club soda, soda water, seltzer water, and fizzy water.

Apart from seltzer water, carbonated waters usually have salt added to improve their taste. Sometimes small amounts of other minerals are included. 

Natural sparkling mineral waters, such as Perrier and San Pellegrino, are different. These waters are captured from a mineral spring and tend to contain minerals and sulfur compounds. They are often carbonated as well.

Tonic water is a form of carbonated water that contains a bitter compound called quinine, along with sugar or high-fructose corn syrup.

SUMMARY

Carbonated water combines water and carbon dioxide under pressure. Sodium and other minerals are often added.

Carbonated water is acidic

Carbon dioxide and water react chemically to produce carbonic acid, a weak acid that’s been shown to stimulate the same nerve receptors in your mouth as mustard. This triggers a burning, prickly sensation that can be both irritating and enjoyable.

The pH of carbonated water is 3–4, which means it’s slightly acidic. However, drinking an acidic beverage like carbonated water does not make your body more acidic. Your kidneys and lungs remove excess carbon dioxide. This keeps your blood at a slightly alkaline pH of 7.35–7.45 regardless of what you eat or drink.

SUMMARY

Carbonated water is acidic, but your body should maintain a stable, slightly alkaline pH no matter what you consume.

Does it affect dental health?

One of the biggest concerns about sparkling water is its effect on teeth, as your enamel is directly exposed to acid.

There is very little research on this topic, but one study found that sparkling mineral water damaged enamel only slightly more than still water. Furthermore, mineral water was 100 times less damaging than a sugary soft drink.

In one study, carbonated beverages showed strong potential to destroy enamel — but only if they contained sugar. In fact, a non-carbonated sweet beverage (Gatorade) was more harmful than a carbonated sugar-free drink (Diet Coke) (Trusted Source).

Another study placed samples of tooth enamel in various beverages for up to 24 hours. The sugar-sweetened carbonated and non-carbonated beverages resulted in significantly greater enamel loss than their diet counterparts (5Trusted Source).

A review of several studies found that the combination of sugar and carbonation may lead to severe dental decay (6Trusted Source).

However, plain sparkling water appears to pose little risk to dental health. Only the sugary types are harmful (7Trusted Source).

If you’re concerned about dental health, try drinking sparkling water with a meal or rinsing your mouth with plain water after drinking it.

SUMMARY

Sugar-sweetened carbonated beverages can erode tooth enamel, but plain carbonated water appears relatively harmless.

Does it affect digestion?

Carbonated water may benefit your digestive health in several ways.

Can improve swallowing ability

Studies suggest that sparkling water may improve swallowing ability in both young and older adults (8Trusted Source, 9Trusted Source, 10Trusted Source).

In one study, 16 healthy people were asked to repeatedly swallow different liquids. Carbonated water showed the strongest ability to stimulate the nerves responsible for swallowing (9Trusted Source).

Another study showed that the combination of cold temperature and carbonation strengthened these beneficial effects (10Trusted Source).

In a study in 72 people who felt a persistent need to clear their throats, drinking ice-cold carbonated water led to improvements in 63% of participants. Those with the most frequent, severe symptoms experienced the greatest relief (11Trusted Source).

May increase feelings of fullness

Carbonated water may also extend feelings of fullness after meals to a greater extent than plain water.

Sparkling water may help food remain in your stomach longer, which can trigger a greater sensation of fullness (12Trusted Source).

In a controlled study in 19 healthy young women, fullness scores were higher after the participants drank 8 ounces (250 ml) of soda water, compared with after drinking still water (13Trusted Source).

However, larger studies are needed to confirm these results.

May help relieve constipation

People who experience constipation may find that drinking sparkling water helps relieve their symptoms.

In a 2-week study in 40 older individuals who had experienced a stroke, average bowel movement frequency nearly doubled in the group that drank carbonated water, compared with the group that drank tap water.

What’s more, participants reported a 58% decrease in constipation symptoms (14Trusted Source).

There’s also evidence that sparkling water may improve other symptoms of indigestion, including stomach pain.

One controlled study examined 21 people with chronic digestive issues. After 15 days, those who drank carbonated water experienced significant improvements in digestive symptoms, constipation, and gallbladder emptying (15Trusted Source).

SUMMARY

Carbonated water has benefits for digestion. It may improve swallowing, increase feelings of fullness, and reduce constipation.

Does carbonated water affect bone health?

Many people believe that carbonated beverages are bad for bones because of their high acid content. However, research suggests the carbonation isn’t to blame.

A large observational study in over 2,500 people found that cola was the only beverage associated with significantly lower bone mineral density. Carbonated water appeared to have no effect on bone health (16Trusted Source).

Unlike carbonated water and clear soda, cola drinks contain a lot of phosphorus.

The researchers proposed that the cola drinkers may have been consuming too much phosphorus and insufficient calcium, providing a potential risk factor for bone loss.

In another study, teen girls who consumed carbonated drinks were found to have lower bone mineral density. This was attributed to beverages that replaced milk in their diet, resulting in inadequate calcium intake (17Trusted Source).

In a controlled study in 18 postmenopausal women, drinking 34 ounces (1 liter) of sodium-rich sparkling water daily for 8 weeks led to better calcium retention than drinking plain mineral water (18Trusted Source).

Additionally, no negative effects on bone health were observed in the sparkling water group.

Animal research suggests carbonated water may even improve bone health.

Supplementing hens’ diets with carbonated water for 6 weeks led to increased leg bone strength compared with tap water (19Trusted Source).

SUMMARY

Drinking carbonated cola drinks may harm bone health, but plain sparkling water appears to have a neutral or positive effect.

Does it affect heart health?

Research suggests carbonated water may improve heart health, although the evidence is very limited.

One study in 18 postmenopausal women showed that drinking sodium-rich carbonated water decreased LDL (bad) cholesterol, inflammatory markers, and blood sugar.

What’s more, they also experienced an increase in HDL (good) cholesterol (20Trusted Source).

Additionally, the estimated risk of developing heart disease within 10 years was 35% lower among those drinking carbonated water than those drinking the control water.

However, since this was only one small study, significantly more research is needed before any conclusions can be reached.

SUMMARY

Carbonated water may have beneficial effects on your cholesterol, inflammation, and blood sugar levels, potentially reducing your risk of heart disease. However, more studies are necessary.

The bottom line

No evidence suggests that carbonated or sparkling water is bad for you.

It’s not that harmful to dental health, and it seems to have no effect on bone health.

Interestingly, a carbonated drink may even enhance digestion by improving swallowing ability and reducing constipation.

It’s also a calorie-free beverage that causes a pleasurable bubbly sensation. Many people prefer it over still water.

There’s no reason to give up this beverage if you enjoy it. In fact, it may even improve your overall health.

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Have a great week, everyone, and thank you for your support!

Blessed be… and happy cooking!

                                                            Chef Michael R